The form below only for for-profit businesses located in Juab, Millard, Piute, Sanpete, Sevier or Wayne county. If you are a Utah for-profit business located outside of those counties, you may wish to contact your nearest Custom Fit Training office to discuss a partnership with them.

Instructions:

Complete this form. Click submit. You will immediately receive a code which you may then enter to purchase tickets at a 50% reduction of cost thanks to Custom Fit Training participation (Custom Fit Training will pay the other 50% of your ticket cost to Snow College).

Custom Fit Training Agreement

Under this training agreement, the Custom Fit Training client (see information below) agrees to pay for 50% of the per employee training fee to attend the Leadercast 2017 event in Ephraim Utah on Friday, May 5, 2017 from 8:30 AM to 4:00 PM. Thus, under this agreement your company will pay the remaining 50% of the fee per employee. You also agree to provide all information requested below which includes the first name, last name and the last four digits of the social security number for each employee (includes owners and partners) who will attend. By completing and submitting this form, you acknowledge acceptance of the terms of this agreement.

Today's date *

PURPOSE OF TRAINING

Check one box to indicate which of the following best describes how this training may help your company: *

Expand or prepare for growthEnhance productivityMaintain a competitive edge

COMPANY INFORMATION

First Name *

Last Name *

Company Name *

Company Street Address *

City, State, Zip *

Phone Number *

Email *

COST INFORMATION

# of attendees *

X

Cost per person *

=

Total Training Cost *

50% Contribution *

In the field above select the number of people in your business for whom you will be purchasing tickets.

In the field above, enter the full fee (before Custom Fit Training Sponsorship) per employee. Note the full fee per employee for tickets you will purchase before March 10 is $99 (Early Bird ticket pricing). General admission tickets purchased after March 10 cost $149.

Multiply the number of trainees by the per-person fee. This is the total training cost.

Custom Fit Training will cover 50% of the cost. This means you will be required to pay the other 50%. Enter the 50% your company will contribute above.

EMPLOYEE INFORMATION

In the space below enter the first name, last name and last four digits of the social security number of each individual for whom your company will be providing tickets.

First Name (1st employee) *

Last Name (1st employee) *

Last 4 digits (1st employee) *

First Name (2nd employee) *

Last Name (2nd employee) *

Last 4 digits (2nd employee) *

First Name (3rd employee) *

Last Name (3rd employee) *

Last 4 digits (3rd employee) *

First Name (4th employee) *

Last Name (4th employee) *

Last 4 digits (4th employee) *

First Name (5th employee) *

Last Name (5th employee) *

Last 4 digits (5th employee) *

First Name (6th employee) *

Last Name (6th employee) *

Last 4 digits (6th employee) *

First Name (7th employee) *

Last Name (7th employee) *

Last 4 digits (7th employee) *

If you have more employees to list, please simply submit the form now, receive your code, and buy tickets. Then call 435.893.2206 and provide the information on additional employees.